Clinical Efficacy Evaluation of Tanreqing Injection Combined with Ceftazidime in Treatment of Phlegm Heat Obstructing Lung Syndrome in Acute Exacerbation of Chronic Obstructive Pulmonary Disease / 中国实验方剂学杂志

ObjectiveTo explore the effect of Tanreqing injection combined with Ceftazide on the clinical efficacy， lung function， and laboratory inflammatory index of patients suffering from phlegm heat obstructing lung syndrome in acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. MethodFrom June 2021 to June 2023， 76 patients diagnosed with phlegm heat obstructing lung syndrome in AECOPD were enrolled in the respiratory and critical medical department of Jieshou Hospital of Traditional Chinese Medicine. They were randomly divided into a control group and an observation group with 38 cases each. The control group used Ceftazidime intravenous drip and other conventional oxygen inhalation and antispasmodic treatment measures of western medicine. The observation group received Tanreqing injection intravenous drip based on the treatment of the control group， with a course of 10 days. The changes of laboratory indicators such as hs-CRP， calcitonin （PCT）， and interleukin-6 （IL-6） before and after treatment were analyzed， and the improvement of forced expiratory volume in the first second （FEV1）， forced vital capacity （FVC）， one second rate （FEV1/FVC）， assessment and improvement of the British Medical Research Society’s dyspnea index （mMRC）， self-evaluation test of chronic obstructive pulmonary disease patients （CAT）， and traditional Chinese medicine syndrome score was compared. In addition， the total effective rate between the two groups after treatment was compared. ResultAfter treatment， the hs-CRP， PCT， IL-6， FEV1， FVC， FEV1/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation of both groups improved （P<0.01）. After treatment， compared with the control group， the observation group showed more significant improvements in hs-CRP， PCT， IL-6， FEV1， FVC， FEV1/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation， and the difference was statistically significant （P<0.05，P<0.01）. The total clinical effective rate of the control group was 86.84% （33/38）， while that of the observation group was 94.74% （36/38）. The therapeutic effect of the observation group was better than that of the control group （χ2=8.471， P<0.05）. ConclusionTanreqing injection combined with Ceftazidime has obvious efficacy in the treatment of phlegm heat obstructing lung syndrome in AECOPD， which is better than the treatment of Ceftazidime antibiotics alone. It can reduce the risk of acute exacerbation， alleviate clinical symptoms， and delay the decline of lung function.

Association between human peripheral blood lipid levels and inflammatory indicators in patients with primary open angle glaucoma / 中华实验眼科杂志

Objective:To investigate the association between serum lipid levels and inflammatory indicators in patients with primary open angle glaucoma (POAG).Methods:A case-control study was conducted.A total of 86 POAG subjects were collected as a POAG group at Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong from January 2016 to March 2022.Meanwhile, 86 with age-related cataract only, matched at age, sex and body mass index were collected as a control group.The intraocular pressure (IOP) and the mean defect of visual field (MD) were measured by Goldmann tonometer and Humphrey field analyzer, respectively.Human peripheral blood samples collected from subjects for serum lipid levels, including total cholesterol, total triglycerides, high density lipoprotein (HDL), and low density lipoprotein (LDL), were analyzed using an automated hematology analyzer and inflammatory markers including C-reactive protein, white blood cells (WBC), neutrophils, lymphocytes, monocytes, were analyzed using an automated biochemical analyzer.Indicators with statistically significant differences between the two groups were selected as independent variables, and multiple logistic regression analysis was used to determine the risk factors for POAG.Correlations between risk factors and ocular parameters (IOP and MD) were assessed using Pearson correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong (No.EC20210313[2]-P03). Written informed consent was obtained from each patient before any medical examination.Results:The HDL was (1.59±0.42)mmol/L in the POAG group, which was significantly lower than (1.76±0.50)mmol/L in the control group ( t=2.435, P=0.016). The LDL was (3.34±0.66)mmol/L in the POAG group, which was significantly higher than (3.08±0.71)mmol/L in the control group ( t=2.520, P=0.013). The WBC was (6.91±1.60)×10 9/L in the POAG group, which was significantly higher than (6.11±1.29)×10 9/L in the control group ( t=3.619, P<0.001). Multiple logistic regression analysis showed that high serum LDL level ( P=0.039, OR=2.354, 95% CI: 1.105-5.303) and high WBC level ( P=0.044, OR=1.310, 95% CI: 1.007-1.703) were risk factors for POAG.Pearson correlation analysis showed that the serum LDL and WBC levels of POAG patients were moderately positively associated with IOP ( r=0.610, P<0.001; r=0.358, P=0.001). LDL level was moderately negatively associated with MD ( r=-0.496, P<0.001). WBC level was weakly negatively associated with MD ( r=-0.235, P=0.030). Conclusions:The elevated peripheral blood LDL and WBC levels are risk factors for POAG onset.The elevated LDL and WBC levels are positively correlated with IOP and negatively correlated with MD in POAG patients.

Associations of systemic inflammatory markers with the risks of chronic heart failure: A case-control study

Abstract Objective: As a greater proportion of patients survived their initial cardiac insult, Chronic Heart Failure (CHF) is becoming a major cause of worldwide morbidity and mortality. However, the mechanism underlying the inflammation in patients with CHF has not yet been elaborated. This study aims to explore the associations between inflammation and CHF patients, and the predictive performance of inflammatory indicators in identifying patients with CHF. Methods: A matched case-control study was conducted by recruiting 385 patients who were diagnosed with CHF from January 2018 to December 2019 in The First Affiliated Hospital of Chongqing Medical University. Each CHF patient was matched against one control subject without CHF on the criteria of age, sex, Body Mass Index (BMI), smoking status, and comorbidities. The clinical data and systemic inflammatory indicators were compared between the two groups, independent risk factors of CHF were identified by multivariate regression analysis, and the predictive values of systemic inflammatory indicators for CHF were analyzed by Receiver Operating Characteristic (ROC) curve analysis. Results: After processed in the univariate and multivariate regression analysis models, three systemic inflammatory indicators (hs-CRP [high sensitivity C Reactive Protein], LMR [lymphocyte-to-monocyte ratio], and Monocyte-to-High-density-lipoprotein Ratio [MHR]) were considered as independent predictors of CHF, among which the hs-CRP exhibited the best predictive performance (AUC = 0.752, 95%CI 0.717‒0.786, p < 0.001), followed by LMR (AUC = 0.711, 95% CI 0.675‒0.747, p < 0.001) and MHR (AUC = 0.673, 95% CI 0.635‒0.710, p < 0.001). The three-indicator combination showed an improved diagnostic performance (AUC = 0.757, 95% CI 0.724‒0.791, p < 0.001). In addition, the results of subgroup comparisons demonstrated that hs-CRP and MHR were associated with the severity of CHF (p < 0.001). Conclusions: The systemic inflammatory indicators such as hs-CRP, LMR, and MHR were independently correlated with the attack of CHF and might be the complementary markers of the diagnosis of CHF. HIGHLIGHTS Two novel inflammation-related markers, LMR and MHR are associated with Chronic Heart Failure (CHF). LMR and MHR were first proposed to be the predictors of a diagnosis of CHF in this study, which suggested that inflammation was associated with CHF, and anti-inflammation therapy might be a potential target for future therapeutic interventions. Compared with special inflammatory indicators such as TNF or IL-1, LMR and MHR are routinely measured in clinical practice and less time-consuming, which makes them suitable for popularization.

Biomarkers of gastrointestinal dysfunction in children / 中国小儿急救医学

Due to incomplete function of gastrointestinal barrier, children are more likely to develop gastrointestinal dysfunction.The clinical application of related biomarkers helps early diagnosis and treatment of gastrointestinal dysfunction in children.By sorting out the studies in recent years, we explored the relationship between inflammatory indicators, intestinal epithelial barrier damage biomarkers, immunological biomarkers, gut microbiome and gastrointestinal dysfunction, and summarized the main problems and solutions faced in the research, which may help the screening, identification and clinical application of relevant biomarkers in subsequent research.

Effect of adequate amount of tranexamic acid before operation on blood loss and safety in posterior lumbar fusion with multiple segments / 中国输血杂志

【Objective】 To investigate the effect of adequate amount of tranexamic acid(TXA)before operation on blood loss and safety in posterior lumbar fusion with multiple segments. 【Methods】 A retrospective analysis was conducted on 105 patients with lumbar spinal stenosis, submitted to our hospital for multilevel PLIF, from March 2017 to December 2019. According to the intervention method, they were divided into control group, group A and group B (n =30, 39 and 36, respectively). TXA was not used in the control group. Dripping of saline solution(100 mL) containing TXA 2g and 1g was given in Group A and Group B, and extra intravenous pumping of TXA [10 mg/(kg·h)] during surgery was conducted in Group B besides the pre-operation dripping of TXA. Total blood loss, dominant blood loss, recessive blood loss, intraoperative blood loss, postoperative drainage volume, transfusion rate and hemoglobin (Hb), hematocrit (Hct), prothrombin time international standardized ratio (PT - INR), platelet count (Plt), D - dimer (D - D), C-reactive protein (CRP), neutrophil percentage (NP), alanine aminotransferase (ALT), and blood urea nitrogen (BUN) before and after operation were compared in the three groups. Postoperative drug-related adverse events were traced. 【Results】 1)The total blood loss, dominant blood loss(mL), intraoperative blood loss(mL), drainage volume(mL) within and after 24h after surgery, and the transfusion rate(%) in group A and B were 892.6±193.5 vs 887.7±320.8, 409.1±109.2 vs, 408.6±98.3, 193.7±69.3 vs 189.6±65.6, 130.5±53.4 vs 128.3±53.5, 63.1±17.6 vs 60.9±13.5 and 7.7 (3/39) vs 8.3 (3/36), respectively, which were significantly lower than that in group C as 1 296.8±329.2, 807.6±231.5, 270.9±65.5, 365.4±127.8, 172.3±66.4 and 36.7(11/30), respectively (P< 0.05). There were no significant differences in the above indexes between group A and group B (P < 0.05). The differences in recessive blood loss was not significant by groups(P<0.05). 2) Compared with pre-operation, the levels of Hb, Hct and Plt in the three groups at 3d after operation decreased: Hb(g/L) 91.5±14.0, 107.6±16.4 and 105.9±17.1; Hct(%) 25.6±3.1, 31.2±3.9 and 30.5±4.4; Plt(×109/L)146.6±31.8, 172.8 ±40.1 and 169.7±39.5(P < 0.05); while D-D, CRP and NP increased: D-D(mmol/L)365.6±67.1, 280.9±50.5 and 286.1±53.1; CRP(mg/L): 65.4±22.0, 53.4±19.6 and 56.8±17.7; NP(%): 87.3±15.6, 73.1±13.7, and 71.9±11.8(P < 0.05), and Pt-INR, ALT and BUN showed no significant changes (P > 0.05). The changes of Hb, Hct, Plt, D-D, CRP and NP in group A and B were significantly lower than those in group C at 3 days after operation [Hb (g/L) : 107.6±16.4, 105.9±17.1, 91.5±14.0; Hct (%) : 31.2±3.9, 30.5±4.4, 25.6±3.1; Plt (×109/L) : 172.8 ±40.1, 169.7±39.5, 146.6±31.8; D-D (mmol/L) : 280.9±50.5, 286.1±53.1, 365.6±67.1; CRP (mg/L) : 53.4±19.6, 56.8±17.7, 65.4±22.0; NP (%) : 73.1±13.7, 71.9±11.8, 87.3±15.6] (P < 0.05), and no significant differences in the above index were noticed between group A and B(P> 0.05).3)No lower limb deep vein thrombosis nor pulmonary embolism were found in group A and group B after operation, and all the incisions were healed in the first stage, and no serious complications such as drug allergy, cardiovascular and cerebrovascular accident, epidural hematoma, epilepsy occurred. 【Conclusion】 The preoperative TXA administration with sufficient single dose showed equivalent hemostatic effect in comparison with intraoperative continuous administration additional to preoperative dripping, which is simple and convenient and does not increase the risk of thrombosis.

Early therapeutic interventions of traditional Chinese medicine in COVID-19 patients: A retrospective cohort study / 中西医结合学报

OBJECTIVE@#To observe the early interventions of traditional Chinese Medicine (TCM) on the conversion time of nucleic acid in patients with coronavirus disease 2019 (COVID-19), and find possible underlying mechanisms of action.@*METHODS@#A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM, at a designated hospital in China. The patients were categorized into three groups: TCM1, TCM2 and TCM3, who respectively received TCM interventions within 7, 8-14, and greater than 15 days of hospitalization. Different indicators such as the conversion time of pharyngeal swab nucleic acid, the conversion time of fecal nucleic acid, length of hospital stay, and inflammatory markers (leukocyte count, and lymphocyte count and percentage) were analyzed to observe the impact of early TCM interventions on these groups.@*RESULTS@#The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5, 7 and 16 d (P < 0.001), with TCM1 and TCM2 being statistically different from TCM3 (P < 0.01). TCM1 (P < 0.05) and TCM3 (P < 0.01) were statistically different from TCM2. The median conversion times of fecal nucleic acid in the three groups were 7, 9 and 17 d (P < 0.001). Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2 (P < 0.01). The median lengths of hospital stay in the three groups were 13, 16 and 21 d (P < 0.001). TCM1 and TCM2 were statistically different from TCM3 (P < 0.01); TCM1 and TCM3 were statistically different from TCM2 (P < 0.01). Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients, with a statistically significant difference observed at each time point in the group (P < 0.001). Statistically significant differences in lymphocyte count and percentage in TCM2 (P < 0.001), and in leucocyte count (P = 0.043) and lymphocyte count (P = 0.038) in TCM3 were observed. The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission (P = 0.044).@*CONCLUSION@#In this study, it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines, TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid, as well as shorter length of hospital stay, thus helping promote faster recovery of the patient. The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.

The expression and significance of Th17 cell/regulatory T cells in peripheral blood of patients with idiopathic inflammatory myopathy / 中华风湿病学杂志

Objective To explore the expression and their significance of peripheral Th17 cells and regulatory T cells (Tregs) in idiopathic inflammatory myopathy,and analyze the relationship between the expression and clinical indicators,imaging and pathological changes.Methods Clinical data,laboratory tests,imaging and pathological changes of IIM cases (n=85) and healthy controls (n=70) were enrolled.Clinical data included the classification,age,gender,course of the disease;laboratory tests including erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),creatine kinase (CK),creatine kinase isoenzyme-MB (CKMB),lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH).The level of peripheral Th17,Treg cells and clinical indicators,laboratory tests,imaging and pathological changes were analyzed retrospectively.Since the data was disregarded from the normal distribution,the median four quantile method was used for statistical description.Two samples were compared with Mann-Whitney U test,and the correlation between variables was Spearman rank correlation analysis.Results ①) The levels of Th17 cells in the case group was not significantly different from that in the control group [6.18(3.42,13.65) cell/μl vs 7.42(5.02,11.13) cell/μl,P＞0.05],the levels of Treg cells in patients was significantly lower than that in the control group [21.25(12.48,35.67) cell/μl vs 36.95(30.37,47.12) cell/μl,P＜0.05],the ratio of Th17/Treg was also significantly higher than that in the control group [0.31(0.21,0.47) vs 0.18(0.14,0.31),P＜0.05].② Peripheral Treg cells levels were not correlated with ESR,CRP,CK-MB,LDH and HBDH (P＞0.05).Peripheral Treg cells levels were negatively correlated with CRP (r=-0.279,P＜0.05),but no correlated with ESR,CK-MB,LDH and HBDH (P＞0.05).③ According to the involvement of important organs,patients were classified into two groups:organ involvement group and non-organ involvement group.The levels of Treg cells in the organ involvement group was fewer than that in non-organ involvement group [16.54(8.84,27.34) cell/ul vs 24.87(14.44,43.37) cell/ul,P＜0.05],and the ratio of Th17/Treg in the organ involvement group was significantly higher than that in non-organ involvement group [0.41(0.29,0.68) vs 0.29(0.19,0.39),P＜0.05].④) Peripheral Th17 cells levels in patients with skeletal muscle inflammatory edema was significantly higher than that of non-inflammatory edema patients [10.70 (4.11,14.51) cell/μl vs 3.10 (1.27,5.15) cell/μl,Z=-2.460,P＜0.05].⑤ The levels of Th17,Treg cells and ratio of Th17/Treg did not correlate with pathological features of inflammatory infiltration (P＞0.05).Conclusion The absolute number of peripheral Treg cells decreases significantly in IIM,and correlates with CRP.Patients with organ involvement have fewer Treg cells,and there is imbalance between Th17 and Treg.When muscle MRI presents with inflammatory edema,patients may have high level of Th17 cells.Our results suggest that Treg cells may play an important role in the pathogenesis of IIM.

The value of T cell spot test of tuberculosis infection and inflammatory indicators for diagnosis of active tuberculosis in patients with fever of unknown origin / 中华传染病杂志

Objective@#To evaluate the value of T cell spot test of tuberculosis infection(T-SPOT.TB) and inflammatory indicators for diagnosis of active tuberculosis in patients with fever of unknown origin (FUO). @*Methods@#Patients with FUO in Tongji Hospital from Jan 1st 2014 to Feb 28th 2015 were retrospectively enrolled, and general condition, laboratory examination including T-SPOT.TB, blood routine test, procalcitonin (PCT), high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), serum ferritin (SF) and final diagnosis were collected and analyzed. @*Results@#A total of 395 hospitalized patients with FUO were retrospectively enrolled into this study, among which there were 36 (9.11%) confirmed active tuberculosis (including 7 pulmonary cases and 29 extra-pulmonary cases), 189 (47.85%) bacterial infections, 50 (12.66%) viral infections, 4 (6.32%) fungal infections, 20 (5.06%) neoplastic diseases, 51(12.91%) autoimmune diseases, 25 (6.32%) other diseases. While 20 (5.06%) patients remained un-diagnosed. The sensitivity of T-SPOT.TB for the diagnosis of active TB in patients with FUO was 80.56% (95%CI: 63.43%-91.20%), and the specificity was 83.57% (95%CI: 79.23%-87.16%). The positive predictive value was 32.95% (95%CI: 23.52%-43.89%), and the negative predictive value was 97.72% (95%CI: 95.16%-99.00%). There were significant differences in positive LDH levels (187[141, 255] U/L vs 209[160, 343] U/L) and SF levels (296.2[191.3, 494.8] g/L vs 528.1[281.1, 1 022.0] μg/L) between active tuberculosis group and bacterial infection group (χ2=77.692, H=13.442, H=16.142, all P<0.05). The combination of T-SPOT.TB and multiple inflammatory indicators obtained most valuable efficiency (AUC=0.866) for TB diagnosis. Similarly, there were significant differences in positive ESR (31[15, 78] mm/1 h vs 10[6, 19] mm/1 h), ratio of neutrophil granulocytes ([71.17±12.59]% vs [57.08±20.38]%) between active tuberculosis group and viral infection group (H=32.797, F=6.171, all P<0.05). The combination acquired most valuable efficiency (AUC=0.929). @*Conclusions@#For patients with FUO, T-SPOT.TB combined with inflammatory indicators are valuable for the diagnosis of active tuberculosis.